Spinal Cord Injury & Finding Supported Independent Living (SIL)

What is Supported Independent Living (SIL)?

SIL is the support or supervision of daily tasks by paid support workers to help you live as independently as possible.

This support can be received individually in your own home, or by a group of people who live together.

Support provided must relate directly to your spinal cord injury and any other conditions recognised by the NDIS.

SIL may be suitable for you if you require both:

• active disability support for more than 8 hours per day to complete daily activities in the home
• some level of support for the other hours

SIL is typically funded for those who require support 24 hours per day, 7 days per week, including overnight support.

Overnight support may be active, where more than two hours of direct assistance is provided. Inactive or sleepover support involves less than two hours of assistance provided to you.

If your support needs are less than this, you may not be considered eligible for SIL.

Does SIL include accommodation?

SIL involves the funding for support provided to you in the home environment. It does NOT include funding for the accommodation where you live.

This means, SIL does not cover the following costs:

• rent, board or lodging costs
• home modifications
• groceries and household supplies

If you require disability-specific accommodation to meet your needs related to your disability, you may be eligible for Specialist Disability Accommodation (SDA).

See further details here: What is SDA and SIL?

Where is SIL funded in my NDIS Plan?

Home and Living (Category 16) is a new category which appears under the Core Supports budget in your NDIS plan.

This funding can ONLY be used flexibly WITHIN this category, not across the remaining CORE budgets.

Is SIL short term or long term?

If you need to move away from your home for a brief period of time, or your existing supports require respite, you can access short-term accommodation (STA).

STA is different from SIL, as SIL is not designed to be a short term solution.

SIL is considered a longer term option, with the primary purpose of supporting you in your home to live alone or with others.

Goals for SIL - What do I want to achieve?

Like all services with the NDIS, SIL must help you to work towards achieving a goal.

SIL should be considered as more than just daily living support. SIL is to provide you with support specifically related to:

• maximising your independence
• Meeting your daily care needs to you to engage in activities that are meaningful to you
• increasing your opportunities for participation in activities and tasks
• ensuring you feel safe and secure

Support provided should be personalised to meet your unique needs related to your spinal cord injury.

How can SIL help me?

SIL services must cater to your individual needs for the various activities that make up your day at home over a 24 hour period. You may require a higher intensity of support in the morning compared to the afternoon and overnight, for example. This needs to be reflected by the SIL provider and the allocation of support.

SIL may include the following supports for you:

• Assistance with personal care, like showering, dressing and toileting
• Assistance with household tasks such as cleaning, preparing meals, washing clothes and cleaning
• Active overnight and/or sleepover support
• Assistance with complex medical needs
• Positive behaviour support management
• Assisting with administering medication and management of health needs related to your disability

What do I need to consider when searching for the right SIL provider for me?

Current Support Needs

It is important you have a clear idea of what your current support needs are to ensure the SIL provider can meet your needs for now, and over the longer term. This makes sure there are no surprises down the track when you request a particular support or service from the SIL team.

It is helpful to have a recent Functional Capacity Assessment (FCA) Report completed by an Occupational Therapist which provides a clear overview of your functional capacity across all activities of daily living. The report should detail your specific support needs, including:

• type of support
• intensity of support
• the ratio of support (how many support staff are needed)
• assistive technology requirements

Find an Occupational Therapist

You need to be clear on what your support needs are before engaging with a SIL provider to make sure they can meet your needs over the long term.

Future Goals

What do you want to achieve over the next 5 years…10 years? Does the SIL service available align with your goals and aspirations?

For example:

• if you want to increase participation in cooking, will the SIL provider be able to accommodate this goal and support you to cook? Alternatively, will they allow for an external support worker to assist you with this goal?
• If your goal is to increase social participation, are there opportunities for residents and staff to cook and dine together as a group? Is there any potential to go out together to a restaurant for a meal?

Consider what the SIL provider can offer you to flourish and live the life you want to live.

Staff Matching, Qualifications and Experience

Enquire about the staff matching process and how the SIL provider ensures that the skills and communication style of the staff members providing your care align with you and your needs. 

Ask how is staff matching is addressed ongoing when new support workers are hired by the SIL provider.

To ensure the SIL provider employs suitably qualified and experienced staff who can meet your care needs, be clear on what your specific support needs involve. 

If you have any disability-related health supports, consider whether these can these needs be met by the SIL provider staff?

Disability-related health supports include:

• Dysphagia supports
• Nutrition supports
• Diabetes management supports
• Continence supports
• Wound and pressure care support
• Podiatry supports
• Epilepsy supports

Find out more about: NDIS Disability-related Health Supports

Staff should regularly engage in continued professional development (CPD) to ensure their skills are up to date. Ask your potential SIL provider about the training schedule for existing and new staff, and whether training is provided in house or externally.

Transparency and Clear Communication

It is important to find a SIL provider who is transparent about their services and can communicate clearly about what they both can and can’t offer.

If you meet with a SIL provider who promises you the world, the chances are that they might not have a clear understanding of your needs and whether it is realistic for them to be met.

SIL providers are required to prepare a Roster of Care for each participant. To ensure you are choosing a provider that has a well-established service, ask for samples or copies of the following documents:

• Roster of Care - this is an NDIS spreadsheet that the SIL provider should have completed for all NDIS participants in their care
• Service Agreement - this outlines all of the terms and conditions you agree to when engaging with their service
• Schedule of Support - this clarifies their rates and fees related to the services provided.

If a SIL provider cannot be transparent and upfront about their service, this may be a red flag that they are not as established as you need them to be to trust them with your care.

Provider Compliance

Providers who deliver supports and services under the NDIS must operate and comply with relevant Australian laws, rules and regulations.

Does the SIL provider meet the necessary compliance requirements?

SIL providers are required to undergo certification audits. The Core Module of the NDIS (Provider Registration and Practice Standards) Rules 2018 requires demonstration of compliance with Practice Standards providing strong oversight measures for NDIS participants in receipt of NDIS support and services, including SIL.

Details about the provider's compliance obligations and the NDIA's compliance monitoring, including what actions may be taken, can be found on NDIS Provider Legal Requirements.

Accommodation Setting

Some SIL providers have a lease agreement with the property where they provide a service. Other SIL providers might own the accommodation setting. 

Perhaps the home is also registered as SDA. Consider if you are eligible for SDA and if you require this funding in your plan to live in this setting and receive support from this SIL provider.

It’s best to visit prospective facilities and settings to help you make your decision whether this is somewhere you would like to live.

Consider the following factors:

• Property accessibility - does the environment align with your needs?
• Location - how close is the setting to your doctor, usual pharmacy, work, day program etc?
• Transport - if you use public transport, are there easy transport options available near the home?
• Home maintenance - is the property maintained well and does it meet your standards?
• Surroundings - do you like living in a busy environment with nearby shops and cafes? Do you prefer a quieter suburban setting?

It is just as important to consider WHERE you will be living alongside WHO will be providing your support. In some cases, SIL can be provided in your own home and you will not have to move.

Resident Dynamic

A lot of SIL settings are shared between residents. If you are entering an existing home where a SIL service is established, you will want to make sure you connect well with the other residents.

Gathering information from the SIL provider about the residents you will be living with will help you to make a decision as to whether this setting is right for you.

Information that could be helpful to know about your potential co-residents:

• Age
• Disability
• History with SIL provider - how long have they lived here?
• Support needs - are these similar to yours?
• Any behaviours of concern?
• Any known triggers or potential risks for conflict?
• What are the minimum and maximum number of residents?

It is not a requirement for all residents to have a spinal cord injury, however, this may be an important underlying factor to consider when matching yourself to an existing setting.

It is important for both yourself and the other residents to feel safe and happy at home. While not essential, it is ideal for you to share a SIL service with residents who have similar support needs to you, so the roster of care can be divided equally when support is shared.

The SIL roster should incorporate individual 1:1 support for you if this is what you require i.e. for personal care routines, however, other supports will likely be in a shared capacity.

When there is a mismatch in resident support needs, there is a risk that you may not be receiving the support that you need. Ask the SIL provider how they will address this to maintain the safety and well-being of all residents.

How do I find a SIL provider?

You are not automatically allocated to a SIL provider. You have choice and control over which provider you engage with for SIL.

The SIL provider you select will assist in preparing a roster of care. This will be submitted to the NDIA alongside any other reports and evidence as part of your Home and Living application.

Get in touch with our Connections Team for assistance in navigating the NDIS and finding a SIL provider in your area.

Find SIL